Unlocking the Inner Athlete, Reengaging Diabetes ManagementFriday, May 25, 2012
Matthew Corcoran, MD, CDE, has created a summer camp for adults with diabetes to get in shape, train for a specific athletic event, and readdress their disease management.
By: John Parkinson, Clinical Content Coordinator, DiabetesCare.net
Over the years, endocrinologist Dr. Matthew Corcoran (pictured here) began to see areas where clinical healthcare could use some improvement, particularly in the delivery of diabetes education and care to adult type 1s.
Dr. Corcoran is a member of the staff of the Joslin Diabetes Center Affiliate at AtlantiCare, a regional healthcare organization, based in Egg Harbor, NJ., and even within a comprehensive care approach setting, Dr. Corcoran felt that there was one area in the field of diabetes management that could still be addressed: exercise.
Possibly one of the biggest issues for any person with diabetes is getting their bodies in sync when they exercise. Understanding how to coordinate physical activity with the right amount of insulin and food is a difficult calculation that has an unpredictable variability to it. Combine this uncertainty with the fear associated with hypoglycemia, and many people with diabetes are reluctant to exercise. It even leads some providers scratching their heads about how to administer exercise advice to this patient population.
Dr. Corcoran also saw patients who had diabetes for years struggle with their overall disease management. He knew firsthand that this patient population was just as susceptible to running into care issues as newly diagnosed patients.
He saw an opportunity to bring together adults living with diabetes to connect, train, and learn how to include physical activity into their diabetes management—similar to what kids learn in their summer camp settings. His passion to bring a unique experience to adults was the onus for the creation of Dr. Corcoran’s Diabetes Training Camp (DTC).
This camp encompasses fitness and athletic training as well as diabetes management education, in a fun atmosphere for like-minded adults with diabetes. One of the important themes at DTC is to get people who exercise or who want to exercise aligned with the physiology of diabetes and help them to understand how the two work in concert.
DiabetesCare.net spoke to Dr. Corcoran about this unique, one-of-a-kind camp, to find out more about the types of people who attend it, what the expectations are for the campers, and what his future plans for the camp are.
DiabetesCare.net: Can you provide an overview of your Diabetes Training Camp (DTC)?
Corcoran: It is an experience and an opportunity for people with diabetes to do three things: train, learn, and connect. DTC is unique because every camper that comes through the door has the opportunity to surround themselves with a team of experts that wants to help them take their health, fitness, training and diabetes management to the next level—whatever that level is.
The camp is designed as a fitness training camp but it also offers education and support from an integrated, multidisciplinary team of amazing experts, including diabetes educators, coaches, and a mental skills coach. Our team is at the height of their industries and they come together each year to motivate our campers to participate in sports and activities.
It also gives campers and staff a chance to be part of a like-minded community—and the power of that community is really incredible.
From aerobics to biking to swimming, DTC offers a wide scope of fitness-related activities as well as classroom instruction and professional coaching to help everyone, from novice athletes to those training for endurance events, enhance their performance.
DiabetesCare.net: Understanding there is going to be some variability in peoples’ abilities, can you talk about the level of athletic skills most of your campers have?
Corcoran: Great question. There is a lot of variability as we see campers of all fitness and training levels. In general, the typical camper is at very average fitness level and they either want to learn how to kick start a routine or take their fitness to the next level. We often will take a person with an average fitness level and help them think through how to train and possibly work on an endurance event.
And these are exactly the type of people we want to meet. I talk with prospective campers about their concerns of being able to keep up with exercise and training, and we ensure them that everyone is able to keep up. We encourage people to go at their own pace, and accommodate everyone’s individual need.
Even when past campers have had preconceived notions of what their fitness level was in relation to other campers, concerns began to dissipate within the first 2 days. The campers all share one common unifying bond—overcoming diabetes. In that sense, they all inspire each other.
DiabetesCare.net: Can you talk about your staff and their level experience and professional training?
Corcoran: The staff is phenomenal; they come to the camp with the highest level of certification or degree within their field. Our head coach, Rick Crawford, is an elite cycling coach. He has coached Lance Armstrong, and now Tour de France competitors. We have also worked with Olympic cyclists and collegiate coaches in the past.
Despite these incredible resumes, they seem to take the greatest pride in helping our campers tap into their own potential—into the inner athlete in all of us, regardless of ability. They always put the camper first. What I look for in coaches and trainers is the humility to understand that they are there to put the camper first. As we like to say in the diabetes field, ‘they get it.’ Our staff is comprised of tremendous coaches, and most importantly, they are great people. I am truly privileged to work with them.
DiabetesCare.net: One of the things you said was having people understanding the physiology of diabetes and how it pertains to exercise. Can you explain what that means?
Corcoran: Clinically speaking, there are many similarities to the physiology of diabetes, fuel metabolism, and exercise in terms of the hormonal response. We are asking people with diabetes—whether they exercise or not—to be their own pancreas. They have to regulate their own fuel metabolism, utilizing the tools that medical providers give them.
So if you can help them understand the physiology of the different scenarios they’ll encounter—and in this case we are talking about exercise—they will understand how to come up with their own individualized plan.
DiabetesCare.net: Do you think exercise gets lost in diabetes management and that providers need to do a better job of advocating and speaking to their patients about it?
Corcoran: Yes. It is something that gets lost within patient care. However, it is not something the healthcare system is set up to accommodate for today.
It’s not that we as medical providers don’t recognize that we should be doing this type of work, but there is a complex set of problems that create this void in terms of clinical education regarding diabetes and exercise.
In the clinic, everyone is crunched for time and there are many aspects of a patient`s care that need to be addressed. There are likely numerous questions the patient needs addressed, or their numbers might be off, and you spend much of the appointment working on titrating medications and going over treatment strategies. Also, some providers may feel like they don’t have the training or expertise to discuss it. Finally, in the current world of insurance, providers are not being reimbursed appropriately for this type of work.
Within the first two days at our camp, we see light bulbs going on. We read on the campers’ faces that they are understanding things better. Most campers may already exercise for an hour a day before coming to camp, so it is not only about managing their diabetes during exercise. Our campers begin to learn how the other 23 hours of the day impacts them and how it relates to exercise. We are unique because we offer campers the information and education that they don’t get in their office visits.
DiabetesCare.net: Aside from the training component, is this camp an opportunity for type 1 veterans to relearn or gain some new disease management strategies?
Corcoran: Absolutely. Our average camper has likely had diabetes for 15 to 20 years. We also have people who come and only have had the disease for a year or people who have had it for over 40 years. We encourage all type 1 adults--no matter how long they have had the disease--to participate in the camp. And, we encourage type 2 adults to participate as well. We have traditionally hosted more type 1 campers, but each year we welcome and witness great strides in exercise and diabetes management for type 2 campers too.
The majority of campers need some diabetes education, and it is a true opportunity for diabetes veterans to relearn or gain some new knowledge. Twenty-five percent of our campers return for at least a second camp experience.
DiabetesCare.net: What are your long-term goals for the camp?
Corcoran: We completed phase one, which was somewhat of pilot of the camp process. This allowed us to see the functionality and what type of outcomes we would have.
At this point, we are in the process of developing a more permanent home for the camp. We’ve gone from delivering the camp to various parts of the country, and now we want to centralize the program. We are also in the process of looking at other camps and workshop activities. We want to target different groups, because each group may have a different need along the way. We want to grow Diabetes Training Camp into a network of services, so that we can continue to help people living with diabetes.
Long-term, the plan remains the same. We want to create a comprehensive resource entirely devoted to diabetes, exercise, and sports, and base it in the clinical expertise that we as a team can bring to the table.
New for 2013: Diabetes Training Camp and DiabetesCare.net have launched their brand new Sponsor-A-Camper to Contest! One lucky person will be able to attend the camp for Free this summer! Go here to learn the contest details and sign up for the contest!
The DTC photos were taken by Michael Holmes.